Heart Patients Take Their Meds, But Won't Exercise

Older patients with heart failure are more likely to take their medications as directed and to keep their office appointments, but they are less likely to follow advice to exercise and to check their weight regularly, according to a new study. Depression, the authors suggest, may contribute to the patients' lack of compliance.

Non-compliance with heart failure medication and diet recommendations contributes to worsening symptoms, leading to hospitalization in many instances. To pinpoint patient-related factors that influence compliance with heart failure regimens, Dr. Martje H. L. van der Wal from University Medical Center Groningen, the Netherlands, and colleagues surveyed 501 older heart failure patients.

Overall, 72 percent of the patients were compliant with their heart failure regimen, the team reports in the European Heart Journal. Compliance with medication and office appointments was "surprisingly high," more than 90 percent, they note. However, compliance with salt and fluid restriction was markedly lower, at 79 percent and 73 percent, respectively. More than 25 percent of patients said they were thirsty because of the fluid restriction and 13 percent found the sodium restriction not palatable.

The lowest compliance rates were for exercise and weighing, with only 39 percent of the subjects complying with exercise advice and only 35 percent getting on the scale daily or at least three times per week.

According to van der Wal's group, a lack of knowledge about heart failure and its treatment seems to be a "serious problem." For example, 14 percent of patients reported that they did not know that it was important to weigh themselves regularly, 30 percent did not know they should restrict fluids, and 28 percent thought they had to drink more fluids in case of thirst.

"It is a major challenge for healthcare providers to improve knowledge of heart failure patients on these subjects," the authors conclude.

Because patients with more depressive symptoms showed more non-compliant behavior in this study, the researchers suggest that "extra attention" should be paid to this patient subgroup.

This article is reprinted from the European Heart Journal.

Yoga May Help Improve Pregnancy Outcome

The practice of yoga during pregnancy seems to improve birth weight and reduce prematurity and overall complications, Indian researchers report.

Dr. Shamanthakamani Narendran, from the Vivekananda Yoga Research Foundation in Bangalore, and colleagues studied 169 pregnant women trained in the integrated approach to yoga and in 166 "controls" who received routine prenatal care.

The yoga training included various loosening exercises, postures ("asanas"), relaxation, deep breathing exercises ("pranayamas"), and meditation, which was practiced for 1 hour daily.

Fourteen percent of deliveries were premature in the yoga group compared with 29 percent in the controls. Rates of pregnancy-related high blood pressure were also lower in the yoga group, the researchers report in the Journal of Alternative and Complimentary Medicine.

"The exact role of yoga is unclear at present," co-author Dr. Vivek Narendran of Cincinnati Children's Hospital and Medical Center in Ohio told Reuters Health.

He said possible mechanisms whereby yoga improves pregnancy outcomes include increased blood flow to the placenta, decreased transfer of maternal stress hormones, and decreased premature release of hormones that trigger the onset of labor.

"Given the larger picture of multiple failed attempts to reduce low birth weight and prematurity globally in the last decade," Dr. Narendran commented, "we provide preliminary data for the first time, to support a simple potential intervention, particularly in India, to improve pregnancy outcomes."

This article is reprinted from the Journal of Alternative and Complimentary Medicine

Listen to SIRIUS Free (follow this link)

Here's a link to a weeklong pass to SIRIUS so you can catch my appearance on the John McMullen show. You can sign up free. No strings. No credit card required.

Sam Gets "SIRIUS" with John McMullen

I'm excited to announce my upcoming work tonight on SIRIUS Satellite Radio with John McMullen, host of the JOHN MCMULLEN SHOW on OUTQ. I've known John for the past 10 years (we met in 2006 when I was a newspaper reporter for the SPOKESMAN REVIEW). Like myself, John's an entrepreneur, shepherding gay and lesbian radio in its many incarnations over the past decade plus. In addition to his soothing, booming radio voice, he's a great (smart) and knowledgeable host. I look forward to fielding his (and your) questions TONIGHT, April 6, between 8 and 9PM Pacific time. It's on SIRIUS, channel 106.

Sam's View: ZMA is NOT Worth the Hype

Dear Sam, Recently I have heard a lot about ZMA, the nutritional supplement. Can you give me any guidance as to how you feel about its effectiveness? —Olan

Olan, ZMA is a combination of two essential dietary minerals (zinc and maganesium) and vitamin B6. Some sources indicate that zinc and magnesium are sometimes "not adequately supplied through normal dietary consumption" thus warranting its use. The zinc in ZMA is in the chemical form of zinc methionine and aspartate; and the magnesium in ZMA is in the aspartate form.

While you may have heard of ZMA as a popular new supplement that claims to increase anabolic hormones and strength in athletes, there is no scientific evidence for any claim that ZMA has any effects beyond those of taking equivalent amounts of zinc, magnesium and vitamin B6 in any other form.

Also, upon investigating further, I've become aware that ZMA was "developed" by Victor Conte, founder of BALCO, and (who according to the ISSA) was recently released from prison. This fact was included in the book Game of Shadows which was written by two reporters from the San Francisco Chronicle regarding the steriod scandals involving Barry Bonds and the 2000 USA track and field team. Based on this additional finding, I would hesitate to recommend ZMA.

Very few nutritional supplements undergo the strict double-blind placebo testing which can demonstrate (or negate) its true effectiveness in the field. Unlike many gyms and trainers, I specifically do not carry supplements in my studios because I feel it is important to maintain my objectivity about them. That's why, when I recommend a product, I do so without any financial tie to the supplement company or product. I feel I owe this to you, my clients and readers, as a fitness professional.

Therefore, I do not recommend use of ZMA at this time.

Babe Got it Right

"Never let the fear of striking out get in your way." --Babe Ruth, the first baseball player in history to hit over 30, 40 and 50 home runs in one season, and also commonly known as The Sultan of Swat.

Get Your Exercise: Rain or Shine

While on vacation last week in Hawaii, we experienced the most rain in that state's recorded history. That's a lot of rain! Of course, we made it through with smiles (it's paradise, after all). But, how do we make the most of the rainy/wet season, especially when it comes to exercise?

Rain may limit your options, but we know that regular cardiovascular exercise is essential to maintaining a healthy heart and lungs. So when it rains, don't get discouraged. Instead, look for indoor activities that approximate your outdoor ones. Take a spinning class, with exciting music. Jump on the elliptical machine or treadmill. Try a power workout like Tae-Bo or Budokan, which is sweeping the nation. If you're pressed for time but really need a quick, effective workout, jump rope. Another great indoor activity is stairclimbing, which is one of the best cardiovascular workouts. If you have the use of a pool, swimming provides an excellent cardiovascular activity without the impact on your joints.

Whether it rains or shines, cardiovascular exercise can become a regular part of your routine. The key is to mix up the training so you don't get bored and stay excited and engaged. Even pumping up your iPod to that next track may be inspiration enough to "stay on track."

Nothing Tops Love

I had the most amazing experience Wednesday evening, proposing to the love of my life, Bronson. I'm honored that he said "yes." He's the most amazing man I have ever known--I love him.